Provider Demographics
NPI:1053498071
Name:LYNCHBURG NEPHROLOGY PHYSICIANS,P.L.L.C.
Entity type:Organization
Organization Name:LYNCHBURG NEPHROLOGY PHYSICIANS,P.L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNIONS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-345-5956
Mailing Address - Street 1:2091 LANGHORNE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1428
Mailing Address - Country:US
Mailing Address - Phone:434-947-3954
Mailing Address - Fax:833-973-4003
Practice Address - Street 1:2091 LANGHORNE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1428
Practice Address - Country:US
Practice Address - Phone:434-947-3954
Practice Address - Fax:434-947-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30015178890001Medicaid